著者

田渕 裕子 大石 雅子 辻本 貴江 小西 祐子 畑 伸顕 清水 健太郎 曹 英樹 和佐 勝史 福澤 正洋

出版者

日本静脈経腸栄養学会

雑誌

静脈経腸栄養 (ISSN:13444980)

巻号頁・発行日

vol.26, no.4, pp.1119-1123, 2011 (Released:2011-08-25)

参考文献数

7

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【目的】経腸栄養剤のpHの変化に対する反応を観察し、1%重曹水を用いた経腸栄養チューブ閉塞に対する効果について検討した。【方法】経腸栄養剤2種 (エンシュア・リキッド®、ラコール®) に酸 (0.1N HCl)、アルカリ (1%重曹水、0.1N NaOH) を添加し、pHの変化に対する経腸栄養剤の凝固の程度を観察した。また、臨床的にも1%重曹水の経腸栄養チューブの閉塞防止効果を検討した。【結果】2試料とも酸に接触すると凝固し、アルカリを加えると凝固物はpH上昇に伴い溶解した。アルカリを加えた場合は外観に変化はなかった。また、経腸栄養チューブ閉塞を繰り返す臨床例に対し、1%重曹水をチューブの洗浄に予防的に用いたところ閉塞を起こすことなく投与続行可能であり、チューブ閉塞症例に対しても開通し投与が再開できた。【結論】1%重曹水は経腸栄養チューブ閉塞防止に有用な手段と考えられる。

著者

大石 雅子 勝浦 正人 片岡 和三郎 黒川 信夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.27, no.5, pp.452-460, 2001-10-10 (Released:2011-03-04)

参考文献数

12

被引用文献数

1 1

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The prevention of endotoxin (ETX) contamination is important for manufacturing injections. As a result, the concentration of ETX in injections has been recently regulated in the Japanese Pharmacopoeia. In this study, ETX in 8 injections prepared at a hospital pharmacy were measured and the removal of ETX by filtration using a charged membrane filter (CMF) made of Nylon 66 (Zetapor®, CUNO) was evaluated. ETX was automatically measured with a Limulus test employing a turbidmetric kinetic assay (Toxinometer®, WAKO). ETX in H2SeO3 and MnCl2 injections were measured without dilution but others need to be diluted to eliminate any interference with the reaction. In particular, the ZnSO4 injection was diluted 2000 times. In the preparations, only 1 % indigocarmin injection showed 0.311 EU/mL of ETX.In a preliminary evaluation, CMF removed ETX completely in the non-electrolytic solutions such as glucose. However, in electrolytic solutions like NaCl, the filtration efficiency of CMF was suggested to decrease by some factors such as the concentration of electrolytes, the pH of the solution and the origin of ETX. In 0.9% NaCl solution to which the control standard ETX was added, the recovery rate of ETX using CMF was 0.3-2%. In 10% NaCl solution, the recovery rate was 37-47% under the same conditions, but it became 75-79% when another origin of ETX was added. In the actual process of preparations, ETX was found in 1 % indigocarmin injection, but it was not found in them when CMF was used. ETX was not removed by a usual filter membrane without any charging and not inactivated completely by steam sterilization. Therefore, filtration using CMF was found to effectively remove ETX together with steam sterilization.Filtration using CMF is thus considered to be a simple and effective method for maintaining a good quality of injections prepared at hospital pharmacies.

著者

大石 雅子 片岡 和三郎 中川 知子 勝浦 正人 池田 賢二 黒川 信夫

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.27, no.3, pp.212-220, 2001-06-10 (Released:2011-03-04)

参考文献数

9

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In this study, the present state of the air cleanliness in the drug preparation room at a hospital pharmacy was evaluated, and factors affecting airborne particle numbers (APN) such as the number and the movement of workers and the materials on working clothes and cloths were investigated. In addition, the effect of environmental conditions on air cleanliness on a clean bench was compared. APN was measured with an Aerosol Particle Counter.The maximum 0.5μm APN values while working in the aseptic preparation room were 3, 610, 1, 312 (less than 10, 000 in GMP) and the non-aseptic room were 8, 008, 2, 660 (less than 100, 000) respectively. The conditions of all rooms were sufficiently suitable for drug preparation according to the criteria of GMP.Concerning factors affecting APN, the movement of workers increased the APN much more than the number of workers. The degree of dispersing particles differed greatly depending on the materials of the working clothes and cloths. A decrease to less than 1 /100 can be obtained by the selection of suitable materials for working clothes such as Overall made of polypropylene non-woven fabric from which few of fibers disperse. It is remarkable that smaller particles are dispersed from clothes even after passing through an air shower. In addition, it was confirmed that the dispersing of particles from cloths and rags was also a problem.As long as prescribed methods were used for the clean bench, the air cleanliness inside the clean bench was kept sufficient even through the external air conditions or locations were not so clean.

著者

大石 雅子

出版者

日本外科代謝栄養学会

雑誌

外科と代謝・栄養 (ISSN:03895564)

巻号頁・発行日

vol.51, no.5, pp.247-255, 2017 (Released:2018-05-14)

参考文献数

21

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静脈栄養は複雑な組成であるが,近年高カロリー輸液キット製剤が多用され,調製の際の汚染やエラーの防止,省力化の点で格段に向上している.しかし年齢や病態によって個別化が必要な場合は注射剤の混合調製が必要である.TPN や抗がん剤の混合調製を薬剤師が行う施設は増加したが,病棟で医師または看護師により,末梢点滴調製や静脈栄養用製剤の加液が行われる施設も多い.清潔,正確,安全な無菌調製の確立はリスク管理上重要である.医療現場は多職種が交代制で業務を行い,情報が変化し多様な薬剤や機器を有する複雑系であるため,ノンテクニカルスキルもまた重要である.注射剤混合時におけるリスクは,微生物や微粒子による汚染,抗がん剤など細胞障害性物質による曝露,各種のヒューマンエラーおよび薬剤保管管理などであり,組織的な対策が必要である.